The audit, spurred by reports nationwide of veterans dying before receiving care at VA facilities, showed more than 57,000 new veteran patients waited at least 90 days before receiving care. Nearly 64,000 veterans enrolled in the VA health system in the past decade and have never received an appointment, according to the audit.

The audit called for additional review at dozens of facilities, including four in West Virginia.

The Clarksburg and Martinsburg medical centers both were flagged for further investigation.

“Any instance of suspected willful misconduct is being reported promptly to the VA Office of Inspector General (OIG),” the audit states.

“Where the OIG chooses not to immediately investigate, VHA leadership will launch either a fact finding or formal administrative investigation. Where misconduct is confirmed, appropriate personnel actions will promptly be pursued.”

The outpatient clinics in Westover, a city in Monongalia County, and Parkersburg were also flagged for further review. VA facilities in Pittsburgh and Washington — other cities where West Virginia veterans seek care — also warrant additional review, the audit states.

Sen. Joe Manchin, D-W.Va., joined 20 other senators earlier in the day to urge U.S. Attorney General Eric Holder and the federal Department of Justice to take a larger role in the criminal investigation of the VA.

While auditors did not determine the Beckley and Huntington VA medical centers needed further review, both have faced scrutiny in the past for prescribing powerful painkillers at some of the highest rates in the nation.

“Our southern West Virginia VA facilities are doing better than many VA facilities nationwide, but not as well as others, and there is certainly always room for improvement,” said Rep. Nick Rahall, D-W.Va.

“The audit confirms, however, that smaller VA facilities, especially in rural and underserved areas, are having trouble hiring care providers and support staff, and that is an area I continue to urge Congress to focus its attention on.”

Almost every VA medical center nationwide scheduled at least 90 percent of appointments within 30 days, and established patients typically waited less than 10 days for an appointment, according to the audit.

A copy of the audit, along with more specific findings from West Virginia VA facilities, is available at www.dailymailwv.com.

Contact writer Dave Boucher at 304-348-4843 or david.boucher@dailymailwv.com. Follow him at www.Twitter.com/Dave_Boucher1.